Table 1 Focus group and interview guides
Focus group guide (discussion topics) | Interview guide (questions) |
|---|---|
1) † We have just heard some reasons why you might need to have such surgery [TKA]. What do you conclude from this? What are the reasons for having TKA? | 1) How many TKAs do you think a hospital performs on average annually? |
2) How many TKAs do you think a hospital performs on average annually? | 2) What number represents a low volume of TKAs for you? |
3) What number represents a low volume of TKAs for you? | 3) What number represents a high volume of TKAs for you? |
4) What number represents a high volume of TKAs for you? | 4) Please comment on the following statement: “The more TKAs a hospital performs, the better the outcome of the TKA”. • In your opinion, which factors influence the outcome of the TKA? • How do you explain the relationship between the number of TKAs performed and the outcomes? |
5) Please comment on the following statement: “The more TKAs a hospital performs, the better the outcome of the TKA” • In your opinion, which factors influence the outcome of a TKA? • How do you explain the relationship between the number of TKAs performed and the outcomes? | 5) Let us say you have a choice between two different hospitals. Hospital A is in your immediate vicinity, so you do not have to travel a long distance. Hospital B is much further away, which means you have a longer travel time. Hospital B has better outcomes of the surgery than Hospital A. Would you be willing to travel longer to hospital to obtain better outcomes of the surgery? |
6) † What would you say if you were to have TKA now and you were informed about the volume of TKAs in the chosen hospital? With what number would you be satisfied, or would you feel comfortable with to say: ‘I will have my surgery there’. What is an acceptable number of surgeries a year for you to say: ‘Yes, they can do it, the result will be good; I will be in good hands’? | 6) What is the maximum travel time you would accept to achieve a better outcomes? |
7) How long on average do you drive to the nearest hospital from where you live? | 7) What other factors (besides distance and case number) would influence your decision to choose a hospital? |
8) How many hospitals do you have in your area? | 8) [Preliminary results of a systematic review are presented to the participant via a previously sent ‘summary of results’ document (Fig. 8) and the explanation (Fig. 9) over the phone]. After explaining the results: Would you say that the number of TKAs/hospital/year has a major impact on the outcomes? |
9) Let us say you have a choice between two different hospitals. Hospital A is in your immediate vicinity, so you do not have to travel a long distance. Hospital B is much further away, which means you have a longer travel time. Hospital B has better outcomes of the surgery than Hospital A. Would you be willing to travel longer to hospital for better outcomes of the surgery? | 9) Based on our calculations, would you definitely rule out one or more of the 3 hospitals if you had planned to have a TKA? |
10) What is the maximum travel time you would accept to obtain better outcomes? | 10) Currently, there is a minimum volume threshold for TKAs in Germany. This means that a hospital has to do at least 50 TKAs/year to receive reimbursement for these surgeries. What would be your opinion if the minimum volume threshold were set to [a number above the number from the 1st hospital] per year and [1st hospital] would no longer be allowed to perform this surgery? |